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Will Trumpcare Affect Employer-Sponsored Plans?

Christian Worstell

by Christian Worstell | Published April 26, 2021 | Reviewed by John Krahnert

The American Health Care Act (AHCA) could potentially have a lasting impact on employer-sponsored health insurance plans. 

Health care spending in the U.S.

Individual States and Essential Health Benefits

Under the GOP health care bill, individual states could be allowed to set their own standards for “essential health benefits,” something that the Affordable Care Act required on a federal level. In turn, employers could be allowed to opt out of meeting Obamacare’s federal standards and instead abide by the state requirements, which may be more relaxed than what the Affordable Care Act mandated. Some of these essential benefits include maternity and preventive services for women along with care for mental health issues, among other things.

Large employers may have the option of adopting the essential benefits requirements of any state under the new proposed legislation, and they could be free to pick the state with the most relaxed requirements.

That could potentially leave employees without some of the benefits that were previously covered under the same plan. States (and thereby employers) would also have the option of opting out of Obamacare’s limits on out-of-pocket costs.

With nearly half of all Americans receiving health insurance through their employer, Trumpcare could affect the benefits of more than 150 million people.

The Provision

The provision has become known as the MacArthur Amendment because it was offered up by Rep. Tom MacArthur of New Jersey just two days before the House voted on (and passed) the bill.

The amendment states that in order for a state to request a waiver of the Essential Health Benefits put in place by the ACA:

States must attest that the purpose of their requested waiver is to reduce premium costs, increase thenumber of persons with healthcare coverage, or advance another benefit to the public interest in the state, including the guarantee of coverage for persons with pre-existing medical conditions.

The American Health Care Act still must pass the Senate, which may make changes to the bill prior to passing.

Learn more about the AHCA with these featured articles:



Kaiser Family Foundation:



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